FOOD SECURITY AMONG OLDER ADULTS IN SUB-SAHARAN AFRICA: A MULTISECTORAL APPROACH
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Background: The Food and Agriculture Organization of the United Nations recently developed the Food Insecurity Experience Scale (FIES) and tested its latent dimensional structure and psychometric properties using the 2014 Gallup World Poll (GWP) data. However, the similarities in psychometric structure of FIES across Sub-Saharan Africa (SSA) that would allow aggregation of food insecurity (FI) results for SSA was not tested. Aims: To, 1) assess the validity of FIES for use in SSA, determine the prevalence of FI by country, age group, and gender, and examine sociodemographic and economic characteristics of individuals with FI, 2) explore the association between FI and place of residence, and poverty in adults aged 50 years and older, and examine whether social capital (networks), social participation (volunteerism, donations, and helpfulness) and social support (emotional and instrumental) attenuate these associations, and whether such associations may differ by gender, 3) examine the associations between proximate factors (food security and physical health) and measures of Subjective well-being (SWB), and other distal risk factors independently associated with SWB, and 4) identify patterns of risk factors associated with SFI among older adults 60 years and above in SSA, and determine the bivariate and multivariate associations between the identified risk factors with severe FI (SFI). Methods: Rasch modeling, classification tree analysis, and logistic regression analyses were applied to SSA data on 57,792 respondents aged 19 years and above in the 2014 and 2015 GWP surveys. Results: FIES has acceptable internal validity for use in SSA. Older adults and women in SSA are at higher risk of FI, and compared to other older adults, urban-poor older men and women are at higher risk for SFI. A broad range of factors explain FI and SWB among older adults in SSA, including social capital, social support and social participation. Other less investigated factors, such as cost of housing and respect of women were also found to be major predictors of SFI among older adults. Conclusions: FI, as measured by FIES, continues to be highly prevalent and needs continued monitoring and multisectoral intervention strategies. Improvements in food security will lead to higher well-being in SSA.